Wellstar Douglasville Medical Center at Villa Rica, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

WELLSTAR DOUGLASVILLE MEDICAL CENTER AT VILLA RICA, LLC

Practice address

403 Permian Way
Suite a
Villa Rica, GA 30180

Phone

(678) 840-4034

Fax

(770) 840-4035

NPI assigned

Jul 20, 2007

Organization subpart

Yes

Parent organization

WELLSTAR HEALTH SYSTEM, INC.As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Nicole Ashe

Title

Executive Director of Finance

Phone

(770) 792-5261

Specialties & licenses 1

Addresses

Part of

NW Ga Nealth Systems in

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215993600000",
    "number": "1710187455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 PERMIAN WAY",
            "address_2": "SUITE A",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "678-840-4034",
            "fax_number": "770-840-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 PERMIAN WAY",
            "address_2": "SUITE A",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "678-840-4034",
            "fax_number": "770-840-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSTAR DOUGLASVILLE MEDICAL CENTER AT VILLA RICA, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WELLSTAR HEALTH SYSTEM, INC.",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-07-14",
        "status": "A",
        "authorized_official_last_name": "ASHE",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "770-792-5261"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charis Re'Nee Warwick-Davis, THERAPIST
• Kari Watts
• Jayla Weaver, M.S., CCC-SLP
• Kendra Webb-Muhammad, LPC
• Martha Juliet Webb, CTRS
• Wellstart Medical, LLC
• West Georgia Christian Counseling, LLC
• West Georgia Diagnostic Testing LLC
• West Georgia Family Medicine Associates, PA
• West Georgia Therapy Center, LLC

• Internal Medicine Physician in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.